Driving Under the Influence: A Review of Fitness to Drive, Drug-Induced Impairments, and Simulation Testing

This literature review examines the concept of fitness to drive and how it can be affected by drugs consumption. The Systematic Literature Review (SLR) methodology is used to analyse the Literature, exploiting Scopus, Consensus and Elicit databases. Firstly, the paper presents research across mechanical engineering and related fields to establish a comprehensive and multidisciplinary understanding of how fitness to drive is evaluated. This includes a definition of the term and the identification of the protocols used for its assessment. Secondly, the emphasis is on the impact of drug use on driving performance, excluding alcohol and cannabis. Driving simulators represent a valid possibility for analysing such effects in a safe, controlled and replicable environment. They are presented considering their most relevant characteristics and the measurements collected for the driver's state analysis. Key findings reveal a lack of a comprehensive taxonomy for fitness to drive, resulting in the absence of a universally agreed-upon definition. On the other hand, the Literature proposes a wide spectrum of tests to assess it. Furthermore, only static driving simulators are used to evaluate drug use, reducing the realism and the reliability of the results obtained. Standard Deviation of Lane Position (SDLP) emerges as a gold-standard measure for assessing driver performance. Future research paths may develop standards for fitness to drive definition and evaluation. Moreover, dynamic driving simulators might represent a natural evolution, being able to develop more realistic scenarios and use state-of-the-art sensors. Finally, multi-drug use may represent a future research path considering more realistic scenarios.